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Search Results: 1 - 10 of 406121 matches for " Renato M Lupinacci "
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Isolated splenic metastasis from lung squamous cell carcinoma
Andre R Dias, Rodrigo A Pinto, Juliana N Ravanini, Renato M Lupinacci, Ivan Cecconello, Ulysses Ribeiro
World Journal of Surgical Oncology , 2012, DOI: 10.1186/1477-7819-10-24
Abstract: Isolated splenic metastasis from lung cancer is an exceedingly rare event. Here, we present the case of an 82-year-old male with previously excised lung squamous cell carcinoma who developed local recurrence and a splenic metastasis. This is only the 17th known report of isolated splenic metastasis, including English and non-English literature.In April 2006, an 82-year-old former smoker male was investigated due to persistent cough. A Computed Tomographic (CT) scan of the chest showed a 2.2 × 1.5 cm nodule in the right mid-lung. Bronchoscopic biopsies revealed a moderately differentiated Squamous cell carcinoma (Figure 1). Preoperative investigation showed no mediastinal lymphadenopathy or distant metastatic disease.The patient underwent a right bilobectomy confirming a moderately differentiated squamous cell carcinoma with large polygonal cells, keratinization, intercellular bridges and keratin pearls (pT2pN2). As margins were scanty, adjuvant chemo-radiation was indicated (4 cycles of Carboplatin and Paclitaxel and 50 Gy). Patient remained asymptomatic and sixteen months after surgery a CT scan revealed a 1 × 1 cm cystic lesion in the spleen (Figure 2). Follow-up was lost and a new CT scan was only performed one year later. This exam revealed an interlobular thickening and an enlargement of the splenic lesion now measuring 6.5 × 6.4 cm (Figure 2). The patient was then referred to palliative chemotherapy with Gemcitabine and received 4 cycles (3 of them with reduced dose due to mielotoxicity). A new CT scan showed stability of the pulmonary disease but progress of the splenic lesion (7.8 × 7.8 cm - Figure 2). Splenectomy was then indicated. During preoperative period the patient presented an acute bowel obstruction. A CT scan of the abdomen and pelvis showed an abrupt obstrutive point at the level of the left colon and the patient underwent an urgent laparotomy. Surgical findings consisted of the large splenic lesion without invasion of adjacent structures and a le
Telescopic straight ileo-anal anastomosis in dogs
Lupinacci, Renato Arioni;Lupinacci, Renato Micelli;Zavadinack Netto, Martin;
Acta Cirurgica Brasileira , 2011, DOI: 10.1590/S0102-86502011000500012
Abstract: purpose: to study outcomes and functional results of a telescopic straight ileo-anal anastomosis. methods: thirty-six mongrel dogs were submitted to total proctocolectomy and telescopic straight ileo-anal anastomosis (ileal mucosa-submucosa pulled-through the rectal cuff). they were divided in 3 groups, sacrificed after one, two or eight weeks after the initial procedure. gross and microscopic (degree of cooptation and signs of ischemia) aspects of the anastomosis, as well, the aspect of defecation were analyzed. results: on microscopy all anastomosis analysed showed a continuous epithelial line and were considered good. after two-months no signs of ischemia were identified. defecation aspect has considerably changed during the study, so no dogs presented solid defecation within the first two weeks, whereas 80% of dogs presented solid stools after two months. conclusion: telescopic ileo-anal anastomosis is a safe alternative and may provide good functional results after some small period of time.
Diverticulopexia no tratamento do divertículo de Zenker Diverticulopexy for the treatment of Zenker's diverticulum
Renato Micelli Lupinacci,Antonio Carlos Pereira Lima,Renato Arioni Lupinacci
Revista do Colégio Brasileiro de Cirurgi?es , 2013,
Abstract: O divertículo de Zenker é um pseudodivertículo que se origina de um defeito muscular na parede posterior da faringe, na área de transi o entre o músculo constritor inferior da faringe e o músculo cricofaringeo. Apesar do avan o das técnicas endoscópicas, o tratamento cirúrgico persiste como o tratamento padr o. Duas técnicas s o possíveis: diverticulectomia (ressec o do divertículo) e a diverticulopexia. As vantagens da diverticulopexia est o ligadas à ausência de anastomose esofágica e suas possíveis complica es: fistulas cervicais, mediastinite, estenose esofágica e infec o de ferida. Em ambas as técnicas a sec o das fibras musculares do músculo cricofaringeo (ou, esfíncter superior do es fago) é fundamental. O objetivo do presente artigo é descrever em detalhes a técnica de diverticulopexia junto ao ligamento pré-vertebral associada à miotomia do músculo cricofaríngeo. Zenker′s diverticulum is a pseudodiverticulum through a muscular defect in the posterior pharyngeal wall at the area between the inferior pharyngeal constrictor muscles of the pharynx and the cricopharyngeus muscle. Although endoscopic techniques have made significant progress, the surgical treatment remains the gold standard. There are two main techniques: diverticulectomy (resection of the diverticulum) and diverticulopexy. The main advantages of diverticulopexy are mostly linked to the absence of an esophageal anatomosis and its possible complications: cervical fistulae, mediastinitis, esophageal stenosis and wound infection, which allows a rapid recover with satisfactory oral intake. The purpose of this article is to describe in details the technique for diverticulopexy to the prevertebral ligament in association with a miotomy of the cricopharyngeus muscle.
Os benefícios da ressec??o anterior baixa em monobloco para o cancer de ovário avan?ado: dez anos de experiência em um único centro terciário
Costa, Sergio Renato Pais;Lupinacci, Renato Arioni;
Revista Brasileira de Coloproctologia , 2008, DOI: 10.1590/S0101-98802008000200003
Abstract: introduction: the cornerstone of ovarian cancer treatment has been the association of debulking surgery with platinum based chemotherapy. when this neoplasm invades adjacent pelvic organs, in order to attain an optimal debulking should be performed an en bloc multivisceral pelvic resection. aim: the objectives of this study were to assess the safety, efficacy and impact on survival of low anterior en bloc resection for primary advanced epithelial ovarian cancer. methods: complete follow-up data were available on 19 patients who underwent this surgical procedure for advanced ovarian cancer between january 1996 and june 2006. these subjects presented a median age of 58 years (24-77). all patients underwent optimal cytoreduction (less than 1cm of residual disease). results: the postoperative mortality was 5 % (n=1) while overall major morbidity was 26,3 % (n=5).the overall three-year survival rate was 77 % while median of survival time was 42 months. conclusions: low anterior en bloc resection, when it is necessary must not be obstacle to obtain an optimal surgery. in despite its high morbidity presents acceptable mortality. long-term disease control may be attained with this approach.
Resultados do tratamento do cancer colorretal (T4) perfurado: análise de 14 pacientes operados
Costa, Sergio Renato Pais;Lupinacci, Renato Arioni;
Revista Brasileira de Coloproctologia , 2008, DOI: 10.1590/S0101-98802008000300001
Abstract: aim: to report on a series of 14 patients with a complicated t4 colorectal cancer (perforated) and describe the outcomes (morbidity, mortality and long-term survival) following curative surgery. methods: complete follow-up data were available on 14 patients who underwent curative surgery from perforated colorectal adenocarcinoma between 1999 and 2007. both epidemiological and surgical findings were analyzed. long-term survival was evaluated too. results: the postoperative mortality was 14 % (n=2). the overall morbidity was 50 % (n=7). ten resections were r0 (71 %).lymph node involvement was present in six patients (43%), and all of them died due to tumor recurrence (4-19 months). six patients (50%) were alive without tumor recurrence (between 18 and 70 months/follow-up). the overall 5-year survival rate was 25% (n=3). conclusion: radical resection (r0) of pefurated colorectal cancer presents high rates of morbidity and mortality. in spite of its high rate of tumor recurrence, this procedure may offer long-term disease control.
Modified posterior pelvic exenteration for advanced ovarian cancer: ten-year experience in 17 resectable cases
Sergio Renato Pais Costa,Renato Arioni Lupinacci
Einstein (S?o Paulo) , 2008,
Abstract: Objective: To assess safety, efficacy and impact on survival of low anterior en bloc resection (modified posterior pelvic exenteration) as part of optimal debulking for primary advanced ovarian cancer. Methods: Complete follow-up data were available for 17 patients who underwent this surgical procedure for advanced ovarian cancer between January 1996 and June 2006. The median age was 58 years (24 to 77). All had epithelial cancer. Seven patients underwent primary debulking, and ten patients underwent interval debulking. All patients underwent optimal cytoreduction (less than 1 cm residual disease) and received postoperative platinum-based chemotherapy. Rresults: The postoperative mortality was 0%, while the overall major morbidity was 23.52% (n = 4). Residual disease after debulking was less than 1 cm in four patients, and was microscopic in 13 patients. The overall three-year survival rate was 76.47%, and the median survival time was 32 months. Cconclusions: When necessary, low anterior en bloc resection (modified posterior pelvic exenteration) should not be an obstacle against optimal surgery. The morbidity rate was high, but the mortality rate was 0%. Long-term survival may ensue from this approach.
Emphysematous cholecystitis
Lupinacci, Renato Micelli;Chafai, Najim;Tiret, Emmanuel;
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S?o Paulo) , 2009, DOI: 10.1590/S0102-67202009000400011
Abstract: background: emphysematous cholecystitis is life-threatening condition characterized by gas-forming infection of the gallbladder. it is mostly seems in old male patients with systemic, specially diabetes and vascular diseases. case report: - a 30-year-old man without previous diseases was admitted because of right upper quadrant pain and nausea. on admission the patient was febrile (38.7o) with normal bilirubin levels. the white blood count was 26700/μl and reactive protein c was 470. axial sections of single slice computed tomography imaging (section thickness 5 mm), revealed gallbladder wall enhancement after i.v. contrast, as well as dilatation of the gallbladder with intraluminal air. the patient underwent open cholecystectomy. the culture of the bile showed clostridium perfringes. the postoperative course of the patient was uneventful. conclusion: this is a rare form of cholecystitis that carries a high mortality and usually present insidious clinical signs. ct is the most accurate imaging technique. antibiotic therapy should begin quickly and include coverage of common pathogens, particularly clostridia. surgical intervention should take place as early as possible.
Hepatectomia regrada e colectomia esquerda simultaneas realizadas por acesso laparoscópico
Lupinacci, Renato Micelli;Machado, Marcel Autran;Lupinacci, Renato Arioni;Herman, Paulo;
Revista do Colégio Brasileiro de Cirurgi?es , 2011, DOI: 10.1590/S0100-69912011000200013
Abstract: laparoscopic approaches have been increasingly used in patients with colorectal or liver cancer. simultaneous colectomy and hepatectomy are considered safe techniques and present similar oncological results regardless of the location of the primary tumor when there are fewer than four liver metastases, since there is no increase in morbidity or decrease in survival. the development of laparoscopic techniques and materials has made the combined resection of the colon and liver a very attractive option. the aim of this study is to demonstrate the synchronous resection of the sigmoid tumor and single liver metastasis treated by purely laparoscopic colectomy and liver left lateral sectorectomy.
A exentera??o pélvica para o cancer de reto: avalia??o dos fatores prognósticos de sobrevida em 27 pacientes operados
Costa, Sergio Renato Pais;Teixeira, Alexandre Chartuni Pereira;Lupinacci, Renato Arioni;
Revista Brasileira de Coloproctologia , 2008, DOI: 10.1590/S0101-98802008000100001
Abstract: aim: to identify survival prognostic factors in patients who underwent curative pelvic exenteration from rectal adenocarcinoma (t4 tumors and isolated pelvic recurrence). methods: complete follow-up data were available on 27 patients who underwent this surgical procedure between 1996 and 2006. multiple prognostic factors were studied by multivariate analysis (epidemiological, surgical and histological). results: postoperative mortality was 7 % (n=2) while overall morbidity was 55 % (n=15). mean of overall survival was 38 months. t4 tumors presented more long-time survival than pelvic recurrence (47 x 26 months). lymph node disease (n+) was single adverse prognostic factor at multivariate analysis. conclusion: pelvic exenteration presents both high morbidity and considerable mortality. it should be reserved for t4 tumors, principally when there was no lymph node spreading.
Pelvic exenteration for locally advanced primary and recurrent pelvic neoplasm: a series of 54 resectable cases
Sergio Renato Pais Costa,Ricardo Cesar Pinto Antunes,Renato Arioni Lupinacci
Einstein (S?o Paulo) , 2008,
Abstract: Objective: To report on a series of 54 patients with pelvic neoplasms submitted to curative pelvic exenteration at a tertiary hospital and describe the results (morbidity, mortality, and long-term survival). Methods: The complete data of 54 patients submitted to pelvic exenteration between 1999 and 2007 were evaluated. Sixteen men and 38 women with a mean age of 65 years and median age of 66 years (36 to 77) were studied. Surgical procedures included total pelvic exenteration (n = 26), anterior pelvic exenteration(n = 5), and posterior pelvic exenteration (n = 23). Rresults: The mean operative time was 402 minutes (280 to 585). The average volume of intraoperative bleeding was 2,013 ml (300 to 5,800). Postoperative mortality was 5% (n = 3). The overall morbidity rate was 46%(n = 25). Histological evaluation demonstrated that 47 resections were R0 (87%) while seven were R1 (13%). The overall survival rate in five years was 23.5% (n = 12). Cconclusions: Despite its aggressive nature and high morbidity, pelvic exenteration is still justified in locally advanced pelvic neoplasms or even in isolated pelvic recurrence, since it affords a greater long-term control of the neoplasm.
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